Active NPI
John Michael Wedin, DDS
- Dentist
- Sweetwater, TX
National Provider Identifier
1609984004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15684
- Practice address
- 905 East 15TH St
Sweetwater, TX 79556 - Phone
- (325) 235-3418
- Fax
- (325) 235-9932
- NPI assigned
- Aug 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15684 | TX | Primary |
Addresses
Primary practice location
905 East 15TH St
Sweetwater, TX 79556
Mailing address
905 East 15TH St
Sweetwater, TX 79556
Phone (325) 235-3418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15684 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446595200000",
"number": "1609984004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 EAST 15TH ST",
"city": "SWEETWATER",
"state": "TX",
"postal_code": "79556",
"telephone_number": "325-235-3418",
"fax_number": "325-235-9932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 EAST 15TH ST",
"city": "SWEETWATER",
"state": "TX",
"postal_code": "79556",
"telephone_number": "325-235-3418",
"fax_number": "325-235-9932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDIN",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-26",
"last_updated": "2015-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "15684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sweetwater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.